• Sara P Bilir, Mitchell P DeKoven, and Juliet Munakata.
• IMS Health, Inc, Health Economics and Outcomes Research, Falls Church, VA, USA. pbilir@us.imshealth.com
• Am J Manag Care. 2020 Dec 5; 18 (5): 234-41.

ObjectivesTo estimate the economic outcomes associated with routine use of bioimpedance spectroscopy (BIS) to aid in the assessment of lymphedema following breast cancer (BC) treatment.Study DesignBudget impact analysis for a hypothetical payer, comparing a "current standard assessment methods" scenario with a hypothetical scenario in which BIS is used routinely.MethodsA payer-perspective decision model was built to calculate the 1-year budget impact of using either current standard methods or BISaided assessments for lymphedema in post-BC patients among a hypothetical payer population. Parameter values were obtained from the medical literature, including population characteristics, lymphedema incidence, resource utilization, and costs associated with assessments and treatment. Alternate scenario analysis incorporated incidence and associated costs of downstream infections and excess mental health care.ResultsWith 627 BC patients in a payer of 1M covered lives, base-case analysis shows cost savings of $315,711, or $0.03 per enrolled member per month (from the payer perspective), from implementation of BIS-aided assessments for lymphedema. Savings improved with consideration of sequelae (eg, infection, hospitalization). However, savings are reduced if specificity of current standard assessments improves by 25% (fewer unnecessary expensive treatments), or if cost of complex decongestive therapy falls by 25%. Sensitivity analysis showed that cost savings results were robust to changes in other model parameters.ConclusionsOver 1 year, BIS-aided assessment of lymphedema for patients following treatment for BC results in cost savings, even without considering potential cost savings associated with averted downstream sequelae.

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